Despite updated guidelines and technological developments that allow for an accurate diagnosis, many asymptomatic individuals have a high risk of developing CAD or cardiac events. The CAC score can estimate a correct risk level for these subjects, which is clinically significant for adequate management of risk factors and obtaining personalized preventive therapy. This systematic review aims to assess the prognostic value of CAC score in asymptomatic individuals. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a systematic literature search was performed to identify original articles since 2010 that evaluated the prognostic value of CAC score in asymptomatic individuals. The quality of the included studies was assessed by the QUIPS tool. A total of 45 articles were selected. Many of these (25 studies) evaluated the prognostic value of CAC score in asymptomatic subjects. In comparison, others (20 studies) evaluated the association of CAC score with other clinical parameters and imaging modalities or the comparison with computed tomography coronary angiography (CTCA). Our findings showed that the CAC score provides valuable prognostic information for predicting CAD risk in asymptomatic individuals.
13 September 2022 in The American Journal of Emergency Medicine
The aim of this study was to inviestigate cardiac and arterial remodelling before and after thoracic endovascular aortic repair (TEVAR) by measuring the Aorto-Septal Angle (AoSA) and the geometric characteristics of the aorta. Five patients were prospectively included. Pre- and post-operative cardio-CTA scans were used to create patient-specific 3D models to calculate the AoSA, defined by the intersection of the aortic and left ventricular axes. Additionally, geometric parameters and the inclination of the ascending aorta (AA) were measured. The results demonstrated a variation between pre- and post-operative AoSA in all patients, with an increase in the case of an aneurysmal disease from 112.36° ± 8.21° to 117.16° ± 9.65° (+4.1%, p = 0.041) and a decrease in the case of aortic dissection from 113.62° ± 0.96° to 107.83° ± 1.45° (−5.1%). Additionally, an increase in the length of both the outer and inner curvatures of the AA was observed from 102.21 ± 10.17 mm to 105.73 ± 11.2 mm (+ 3.33% p = 0.016) and from 55.55 ± 9.53 mm to 58.35 ± 9.96 mm (+4.8%, p = 0.04), respectively. This study introduced a new repeatable and reproducible method for assessing the AoSA using cardiac-CTA images. Thoracic stent deployment changes the AoSA, potentially impacting long-term left ventricle hemodynamics.
1 June 2022 in The American Journal of Emergency Medicine